A profile of community navigation in adults with chronic cognitive impairments.
PRIMARY OBJECTIVE: This study sought to identify navigation patterns and illuminate the barriers to and possible solutions for independent community travel in people with chronic cognitive impairments as a result of acquired brain injury. RESEARCH DESIGN: Two investigative methods were used to explore navigation in the population of interest: Study 1 was a field study and study 2 convened a series of focus groups with relevant stakeholders. METHODS AND PROCEDURES: For study 1, each week during a 4 month period, researchers administered a navigational survey and structured interview to a typical case sample of six participants in order to catalogue all trips taken outside the assistive living facility. Study 2 convened six focus groups to access perspectives on navigational issues for individuals with cognitive impairments (CI) from a number of stakeholder groups including individuals with CI, care providers for this population and public transportation workers. CONCLUSIONS: The results of both studies were consistent and indicated that community access is severely restricted for individuals with CI. The majority of trips that were taken tended to be routine and assisted. The variety of travel was limited; participants ventured to the same set places with the same people. Participants described barriers accounting for these problems and suggested a number of strategies to minimize problems.